Bariatric Surgery in Indonesia

Bariatric surgery is a group of weight-loss surgeries that involves making changes to the digestive system, some of which are non-reversible. The idea behind these types of surgeries is to help patients lose weight by either limiting the amount of food they can consume/digest at any one time or reducing their body’s ability to absorb nutrients. Some procedures do both. 

Bariatric surgeries should only ever be the final option when diet and exercise have proved inadequate and there are now serious health concerns caused by a person's weight. In general, these surgeries can only be an option for patients whose body mass index (BMI) is 40 or higher (extreme obesity). In certain cases, patients whose BMI is 30 to 39.9 may qualify for certain types of bariatric surgery if they have serious weight-related problems, such as type 2 diabetes.

The three most common types of Bariatric Surgeries are as follows:

1. Gastric Sleeve – The most common surgery, in which about 80% of the stomach is irreversibly removed, resulting in a sleeve or tube-like structure. This smaller stomach will not be able to hold as much food and produces less of the hormone that regulates appetite (ghrelin), which can lessen the patient’s desire to eat. 
2. Gastric Bypass – A more complicated procedure in which the stomach is divided into two parts; a small upper pouch and a large lower ‘remnant’ pouch. The small intestine is rearranged to bypass the large pouch. As a result, the volume of the stomach is significantly reduced. This causes food to go into the small upper pouch of the stomach and then directly into the small intestine. The small upper pouch can only hold around an ounce of food. Gastric Bypass is typically not reversible. 
3. Gastric Band – Involves an inflatable silicone device that is fitted around the top portion of the stomach to create a smaller stomach pouch. This procedure causes the patient to feel fuller with less food but still allows the body to digest food as usual, without malabsorption. The device can be removed when the patient reaches their desired weight.

The bariatric surgeries mentioned above are typically performed laparoscopically, in which the surgeon creates around one to five small incisions in the abdomen to insert a laparoscope (a long narrow tube with a camera) and surgical tools. The patients are usually given a general anesthetic, so they will not feel anything throughout the surgery.

How Long Should I Stay in Indonesia?

After bariatric surgery, an overnight stay in the hospital is usually required. In some cases, you may need to stay longer (around 3 to 5 days). However, it is not advisable to leave Indonesia as soon as you are discharged from the hospital. Stay at least 10 to 14 days following your surgery for initial recovery and follow-up checkups. During the follow-up checkups, your surgeon will remove your stitches and check your overall condition.

What's the Expected Recovery Time?

The recovery time may take around 3 to 6 weeks until you are allowed to go back to your normal activities, including work, with some restrictions. You must avoid heavy work and strenuous activities, such as lifting, pushing, or carrying heavy loads for at least the first three months after surgery. You should also avoid sitting and standing without moving for long periods to avoid blood clots forming in your legs.

What Aftercare is Required?

You will be given a special diet plan immediately after your surgery, as well as detailed post-operative instructions. Make sure to follow the diet plan and instructions to avoid complications and speed up your recovery. In order to maximize and maintain weight loss, it is important that you commit to healthy eating and regular exercise. There may be restrictions on how much food you can consume. You may also need to change your eating habits, such as eating 6 small meals instead of 3 large meals each day. You should take vitamins and mineral supplements to ensure proper nutrition. 

What's the Success Rate?

The success rates vary for each of the different types of bariatric surgery. In general, within the first six months following the surgery, most patients lose around 30% to 55% of their excess weight. Then, as early as 12 months after surgery, most patients lose over 70% of their excess weight. Patients could also maintain a 50% to 60% loss of excess weight for 10 to 14 years after their bariatric surgery. Although the success rates are high, there are risks associated with bariatric surgery, such as bleeding, deep vein thrombosis, infections, spleen injury, stenosis, and infections.

Are there Alternatives?

There is a non-surgical Bariatric procedure, known as the Gastric Balloon. This involves an inflatable device that is temporarily inserted into the stomach via endoscopic placement. A sizable area of the stomach is obstructed by the balloon or balloons, thus reducing the amount of food it can contain at any one time, leading to eventual weight loss. The balloons are usually removed after 6 or 12 months. 

If you cannot or do not want to undergo any surgery or medical procedure, you may be able to work with a doctor who is experienced in treating extreme obesity and a dietician as the alternative. They may recommend you to change your diet, adding physical activity, and prescribe medications.

Bariatric Surgery in and around Indonesia

About Indonesia

Indonesia is a country in Southeast Asia, located between the Indian and Pacific oceans. It is the 4th most populous country in the world with over 260 million inhabitants. The country consists of more than 17,000 islands, which makes it the largest island country in the world. It is packed with beaches, volcanoes, tropical jungles, exotic animals, and culture. This wonderful country invites any adventurous traveler to explore its dramatic landscape. Today, Indonesia is also a potential medical tourism destination. Although it is not as popular as its neighboring countries such as Malaysia, Singapore, and Thailand in terms of medical tourism, the country actually houses numerous excellent medical centers. Many of the medical practitioners are well-trained and can communicate in English. The medical centers are equipped with cutting-edge technology and offer a wide range of affordable treatments. Some of the most sought-after treatments are blepharoplasty, liposuction, and breast augmentation.

Popular Parts of Indonesia

From busy metropolises, and sparkling beaches, to tropical rainforests, tourists will be able to find anything they want here.

• Jakarta is the capital of Indonesia. It is the melting pot of Indonesia's many cultures because thousands of people from all over the country live and work here. The city is home to numerous museums, some of which are the biggest in the country, such as the National Museum of Indonesia and the Museum of Modern and Contemporary Art in Nusantara (MACAN). The most famous landmark in the city is the National Monument or Monas which commemorates the Indonesian struggle for independence. The city also has a unique old city known as Kota Tua, where tourists can find many interesting colonial buildings.  
• Bali is Indonesia’s main tourist destination which attracts more than 15 million tourists every year. The island is packed with striking beaches, diverse marine life, jungle-covered mountains, lively nightlife, opulent culture, and spiritual energy. Almost every beach on the island is worth visiting, particularly Seminyak, Nusa Dua, Sanur, and Padang Padang Beaches. You can visit the Pura Tanah Lot and witness its scenic beauty or go to Ubud Monkey Forest to watch the monkeys and explore the sacred temples.
• The Special Region of Yogyakarta is the center of Java’s traditions and it is the only region in Indonesia that officially recognizes the monarchy. The region is home to numerous ancient buildings and temples. Visit Borobudur temple in the early morning to watch the sunrise, and watch the sunset from Prambanan or Ratu Boko temples. Tourists who are eager to learn about the region’s past can wander around Taman Sari, a park of palaces, pools, and waterways belonging to the sultan.
• Medan is the largest city on the island of Sumatra and it is a gateway to the western part of Indonesia as well as a busy trading city. The most important attraction in Medan is Lake Toba which is one of the natural wonders of the world. It is a massive crater lake with an island in its center. The island, named Samosir, is almost as big as Singapore. This enormous lake has a depth of 450 meters, making it more like an ocean rather than a lake. The clear lake with picturesque mountains in the background gives an incredible view that will leave anyone in awe.
• Bandung is widely known as Parijs van Java or the Paris of Java because of its resemblance to Paris and European cities. Located on a river basin surrounded by volcanic mountains, it has a significantly cooler temperature than any other part of Indonesia. The city is a weekend gateway for people from the surrounding cities and it is popular for its delightful food, fashionable boutiques, creative arts, and lush green spaces. The city is filled with Art Deco, Neoclassical, and Gothic buildings such as the Savoy Homann Hotel and De Vries Building.

Weather and Climate in Indonesia

Indonesia experiences an entirely tropical climate. The average temperatures can vary based on the area. Coastal areas have an average temperature of 28 °C, the inland and mountain areas have an average of 26 °C, and the higher mountain areas have an average of 23 °C. There are two seasons in the country, but the seasons can start differently in each region. Generally, June to October is the dry season and November to March is the rainy season. The dry season is influenced by the Australian continental air masses and has a slightly cooler temperature than the rainy season. Tourists can expect mostly sunny days, but there will be some short rain showers. The rainy season can be very humid, and wet, and has a significant amount of rain.

Getting Around in Indonesia

Indonesia is well-connected by airports in almost every region. However, the largest airports are Soekarno-Hatta International Airport in Jakarta and Ngurah Rai International Airport in Bali. Both airports serve domestic and international flights to major cities around the globe. There are budget airlines in almost every airport, including Air Asia, Citilink, and Wings Air. Domestic flights can be rather expensive but will make traveling around the cities a lot easier. 

Getting around the islands of Java and Sumatra can easily be done by trains operated by PT. KAI. There are 5 classes of trains: economy, business, executive, priority, and sleeper. The economy class can be a little uncomfortable and crowded, but tourists can get around several cities for as low as $4. Since the country is an archipelago, tourists can also travel from one island to another by ferry boats (long-distance) and speed boats (short distances such as Bali to Lombok).

Most of the cities will have their own mode of transport. The most common mode of transport is taxis and buses. Taxis are normally metered, but some drivers refuse to use the meter and force tourists to pay a fixed fare. Tourists should avoid riding these kinds of taxis and always insist on using the meter. The most reliable taxi companies are Blue Bird and Express. Bigger cities like Jakarta have MRT, LRT, and KRL (local trains).

Tourist Visas in Indonesia

Citizens of 170 jurisdictions can visit and stay in Indonesia for up to 30 days. Visa on arrival is available for 68 countries including Japan, the United Kingdom, and the United States. Nationals not listed in the visa exception agreement and visa on arrival need to obtain a visa before entering the country. It is advisable to check at your nearest Indonesia Embassy or Consulate for the visa policy. All visitors will need to have a passport valid for at least 6 months and a valid return ticket.

Additional Information

1. Local Currency: The local currency is Indonesian Rupiah (Rp) and $1 will get you approximately Rp14.000.
2. Money & Payments: ATMs that accept international cards are widely available in many cities. Credit cards are accepted in most established restaurants and hotels. If you are planning to visit small towns, it is advisable to carry some cash. Tipping is not essential but will be highly appreciated.
3. Local Language: The official language is Bahasa Indonesia and people in major cities and tourist areas will speak and understand English.
4. Local Culture and Religion: Most of the population follows Islam, but there are small groups of Hindus, Christians, Buddhists, and Confucianism. It is important to know that Indonesian people are friendly and conservative. Avoid wearing revealing clothes except on the beach.
5. Public Holidays: Indonesia celebrates numerous national and religious holidays such as Independence Day, Eid Mubarak, Christmas, Vesak, and Nyepi.